An E.R. Physician on What It’s Like to Treat Toddlers Who Have Been Separated from Their Parents at the Border

President Trump announced yesterday that the policy of taking immigrant children from their parents at the border will end, but there are no immediate plans in place for reuniting these families.

Photograph by John Moore / Getty

Tara Neubrand is a pediatric emergency-medicine physician at a large hospital in Denver, Colorado, which has one of the main pediatric trauma centers in the area. She and her colleagues frequently treat kids who have been abused or have experienced other traumatic events, and who have been placed in the foster-care system. Since April, she has seen three toddlers from Guatemala and Honduras—two boys and a girl who were forcibly separated from their parents by Border Patrol agents at the U.S.–Mexico border.

The children were between the ages of one and two. In each case, Neubrand met the child and his or her foster mother when they came to the E.R. for minor medical issues: colds, rashes, vomiting. (In Colorado, foster parents are required to seek medical care before providing any treatment for children, which is part of why Neubrand sees such cases frequently.) The children had been with foster families for two weeks or less at the time of their E.R. visits. These were experienced foster parents who had taken care of multiple children in the past.

This time, however, the families received little of the information that is normally provided by caseworkers when a child is placed in foster care. They didn’t know where the toddlers’ parents were, except that they were in Immigration and Customs Enforcement detention. They didn’t know whether the children had allergies or were vaccinated or needed medication. They didn’t know if the toddlers had siblings. They didn’t know how long the children would be staying with them, or whether they would eventually be reunited with their families. And the children are all too young to communicate any of that information to their foster parents.

Although President Trump announced yesterday that the policy of taking children from their parents at the border will end, there are no immediate plans or mechanisms in place to reunite parents with the estimated twenty-five hundred children—including the three whom Neubrand treated—who have already been taken, often under chaotic circumstances in which basic information was not recorded. Neubrand was getting ready for an overnight shift on Tuesday afternoon when she spoke with me by phone about her experiences treating these children. Her account has been condensed and edited.

“Toddlers who show up in the E.R., even if they’re not feeling well, they climb on everything. They climb on the bed, they climb on the chairs. We have toys on the walls they can play with, we have stickers, because toddlers need to stay busy. That’s just what they need to do. And all three of these kids were clutching their foster mothers. I mean, little tiny clenched fists just wrapped around their foster mothers’ necks. And the mothers couldn’t put them down. Every time the foster mothers tried to move them, so I could examine them, the kids would scream, scream, scream, and just claw at their foster mothers.

“The foster mothers all told me that they were like that in their homes, as well. Just desperate, absolutely refusing to be put down, refusing to go out and push their boundaries and explore their world the way that toddlers are supposed to explore.

“One mother asked me for advice, because she was having a really hard time just getting the little girl into the bathtub. She couldn’t get her in safely without this little girl trying to climb out of the tub, trying to jump out of the tub, jump back on the foster mother. She told me that if that were her biological kid she would just get in the bathtub with her, because she knew that that was what she needed, but she couldn’t do that because she was a foster mother.

“One of the little boys, the third child I saw, kept yelling ‘Papa, Papa, Papa,’ all the time. The foster mother was in tears, saying, ‘I’m just trying not to ruin his life.’ It was heartbreaking. She was a caring foster parent who was doing her best and had very clear recognition that her best was not good enough. There was very little she could do to comfort this kid. She could pick him up, she could hold him, but she couldn’t talk him through anything. She couldn’t tell him when he was going to see his parents again, if he was going to see his parents again, where they were, if he could talk to them. She didn’t know.

“I see a lot of bad things in the emergency department. I see a lot of child-abuse cases, but I don’t see cases where someone has intentionally inflicted pain on children when it’s not a specific child-abuse case. It was so striking to me because—it really does, truly, feel like government-mandated child abuse.

“In a normal child-abuse case, I can identify the person who hit the kid, beat the kid, burned the kids. All of those stories are terrible. I wind up frequently testifying in those cases, and so I have some role in the protection, in the advocacy for those kids. And, in this case, I don’t have any role, I don’t have any way to advocate for them or protect them or make sure that they get justice.

“I see a lot of child separations in criminal cases. But even when parents go to jail for criminal cases—and this is, people have actually been convicted—they don’t lose their parental rights. They have the right to know where their kids are, and they have the right to know who’s taking care of them, and they have processes they go through to get their kids back. Our child-protective services very much default to family reunification. They do not default to family separation.”